27/11/2025
CQC’s consultation ‘Better regulation, better care: Consultation on improving how we assess and rate providers’ marks the next stage in its rebuilding process following the extensive criticisms of the Single Assessment Framework (“SAF”) (launched in early 2024) and the review of the regulator’s operational failings set out in the reports of Dame Penny Dash, Professor Sir Mike Richards, and the Care Providers Alliance.
In this alert we look at what the Consultation proposes in terms of:
- How frequently will services be inspected?
- What will inspection reports look like?
- What will be done in terms of relationships with providers?
How frequently will services be inspected?
One of the long running concerns with CQC has been the number of services across the country which have not been inspected since they were registered and, for the those that have, the length of time since which has elapsed since. It is this that has seriously undermined CQC’s ability to provide a true up to date picture of the quality of healthcare across the country.
Indeed, the need to be able to update ratings more frequently was one of the drivers behind the SAF, and which the SAF has failed to deliver. As of January 2025, the average age of all issued CQC ratings was 4 years and 1 month. This is clearly unacceptable.
Against that backdrop, the Consultation announced that, in addition to Rapid response inspections, where immediate and specific concerns are identified, CQC will carry out Routine planned inspections, taking a broad and detailed look at the quality and safety of services, covering all five Key Questions (if not every part of the assessment framework) on a “3 to 5-year cycle, depending on the type of service, and on information and changes in quality over time”.
There are two points which occur here: firstly, this proposal, as stated, does not appear to amount to any material improvement on the current position regarding the average age of ratings. Secondly, there is again a lack of detail and clarity as to what this means: does this mean, for instance, that the most frequent 'routine planned inspections' CQC will carry out (presumably of services rated 'Inadequate'), will be carried out every three years?
Inspection Reports
The Consultation also states that CQC intends to “co-design a new approach to inspection reports, to make them clearer and more useable for our audiences”.
Whilst noting that inspection reports need to enable the public to quickly and easily understand the quality of the services they use, CQC also acknowledge that providers need detail in reports to understand why they have received a particular rating.”
This is a welcome acknowledgment, although we will need to see what this looks like in practice - again it is hoped that there will be engagement with providers on this. One aspect of the current SAF reports which it would be helpful to rectify is that, in the current reports where there are identified breaches of the regulatory requirements, the reports do not specify which of the factual findings CQC considers amount to the breach of the regulations; this is somewhat bizarre and it is important for the regulator to be clear about these issues.
Relationships with Providers
In terms of the concerns which have been expressed about the need for clearer relationships between providers and CQC, the Consultation states “we are working to ensure that large providers such as NHS trusts always have a clear point of contact within CQC with a member of our staff so they can discuss any issues in their service and their experience of our work.” – However, no details are provided as to how this will work and no mention is made of whether there will be similar clear points of contact for large independent sector providers.
All stakeholders are encouraged to review and engage with the Consultation before it closes on 11 December 2025.
If you wish to discuss any issues arising from the Consultation with us, please contact Carlton Sadler, Tracey Longfield, or Lindsey McNee.
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